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Medicaid Review Analyst
Location:
Fredericksburg, VA
Description:
Medicaid Review Analyst General Description: Medicaid Review Analyst will utilize claim processing, federal regulation and state policy knowledge andexperience in accurately complete data processing reviews as they relate to the task order, includingcompliance with contract deliverables, internal and external performance requirements, and continualimprovement. This position is responsible for providing support to the Data Processing Review Management staff andOperations area. In assuming this position, you will be a critical contributor to meeting Prime mission. Todeliver innovative, cost effective solutions and services that enable our customers to rapidly adapt todynamic environments. Specific Tasks: • Knowledge of, and the ability to correctly identify, insurance coverage guidelines• Familiarity with CPT codes, ICD-10-CM codes, and HCPCS codes Knowledge of and ability to useMicrosoft Word, Excel and Internet applications• Working knowledge of medical terminology and experience in the review of Medicaid electronicclaims are required as well as experience related to specific workload of the individual taskorder, which may be further defined in the Task Order Statement of Work.• Communicates internally with all levels of PERM Complies with departmental policies andprocedures• Complies with Statement of Work (SOW) guidelines and CMS directives and regulationspertaining to improper payments in the Medicaid and CHIP programs Attends departmental andrequired education and training programs• Performs other projects or duties as assigned by the Data Processing Review Manager or Lead Medicaid Reviewer Education: • Bachelor's degree or equivalent work experience, and at least one (1) year experience withMedicaid/CHIP data.Skills & Knowledge Abilities:• Must live within reasonable commuting distance of a major airport• Knowledge of, and the ability to correctly identify, insurance coverage guidelines• Familiarity with CPT codes, ICD-10-CM codes, and HCPCS codes• Knowledge of and ability to use Microsoft Word, Excel and Internet applications• Working knowledge of medical terminology and experience in the review of Medicaid electronicclaims are required as well as experience related to specific workload of the individual taskorder, which may be further defined in the Task Order Statement of Work.• Must have no adverse actions pending or taken against him/her by any State or Federallicensing board or program• Must have and maintain a valid driver's license for the associate's state of residence. Experience: • Ability to quickly adapt and thrive in a changing work environment.• Ability to read insurance claims, both paper and electronic, and a basic knowledge of theinsurance claims systems
Company:
Catapult Consultants
Posted:
December 26 2023 on ApplicantPro
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More About this Listing: Medicaid Review Analyst
Medicaid Review Analyst is a Jobs Analyst Job at Catapult Consultants located in Fredericksburg VA. Find other listings like Medicaid Review Analyst by searching Oodle for Jobs Analyst Jobs.
Medicaid Review Analyst is a Jobs Analyst Job at Catapult Consultants located in Fredericksburg VA. Find other listings like Medicaid Review Analyst by searching Oodle for Jobs Analyst Jobs.